VantageLinks is a dedicated Information Technology (IT) staffing company supporting our clients with all their IT Needs. We currently have an opening for a BA IIII: Optum Pricing Configuration Analyst with one of our premier clients.
THIS IS A DIRECT ROLE WITH OUR CLIENT. WE ARE UNABLE TO ACCEPT H1B CANDIDATES AND PLEASE NO STAFFING AGENCIES.
Position Purpose: The Optum Pricing Configuration Analyst is responsible for configuring the Optum Rate Manager, Easy Grouper, and Multi-Pricer products based on Medicare, Medicaid, and Market Place requirements, so that claims are paid correctly based on federal and state rules. The Optum Pricing Configuration Analyst works with Contract Implementation Analysts from various Health Plans to analyze and implement new projects and configuration requests.
- Perform detailed analysis on multiple change requests and projects, recommend business solutions, and ensure successful implementation Configure Optum Rate Manager, EasyGroup, Multi-Pricer based on Health Plan requirements, so that claims are priced correctly
- Configure Amisys Advanced based on Health Plan requirements, so that claims are priced correctly
- Perform research and analysis on why claims are not pricing correctly
- Work with Contract Implementation Analysts, Claims Analysts, and other Stakeholders to implement new pricing
- Assist during testing and user acceptance testing phases
- Manage implementation of Optum product updates for Rate Manager, EasyGroup, and Multi-Pricer
- Query data in order to troubleshoot issues
- Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
- Identify and analyze user requirements, procedures, and problems to improve existing processes
- Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations
- Identify ways to enhance performance management and operational reports related to new business implementation processes
- Coordinate with various business units and departments in the development and delivery of training programs
- Develop, share, and incorporate organizational best practices into business applications
- Diagnose problems and identify opportunities for process redesign and improvement
- Formulate and update departmental policies and procedures
Serve as the subject matter expert on the assigned function product to ensure operational
- Ability to travel
Benefits and Payment Configuration:
Bachelor’s degree in related field or equivalent experience. 4+ years of business process analysis, preferably in healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience. Advanced knowledge of Microsoft Applications, including Excel and Access preferred. Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Knowledge of managed care information or claims payment systems preferred. Previous structured testing experience preferred.
- Very strong ability to research and analyze complex problems
- Experience working with multiple stakeholders and business owners distributed throughout the United States
- Optum Rate Manager, EasyGroup, Multi-Pricer, and Webstrat experience
- Amisys Advanced benefits and pricing experience
- Experience with MS-DRG, APC, EAPG, APR-DRG payment methodologies
- Healthcare industry experience
- Experience working with claims
- Data analysis experience
- SQL and relational database experience
- Customer service mindset
- Team oriented mindset
What are the 3-4 non-negotiable requirements on this position?
Must have Optum Configuration Experience. Must have healthcare experience. Must have BS/BA plus 4 years of experience, or eight years in lieu of a degree